Gerald Nash (Louth, Labour)

At the outset, I will say to the Minister that words count and leadership matters. I thank the Minister for calling out the inhumanity and cruelty that is so sadly being imported into this country and mimicked by some of those who should know better. Those people need to act and behave with more responsibility in respect of their fellow citizens.

As with everyone else in our State, the level of access trans people have to healthcare depends at least in part on the attitude of their medical professionals. We cannot allow that to continue to be the case. Care is not consistent. For example, in my office, we have been dealing with the case of a trans woman who transitioned nine years ago and was discharged from the national gender service post surgery with instructions for her GP to manage her ongoing hormone therapy. That was all fine until she decided to move and had to register with a new GP, who simply refused to continue prescribing HRT unless she saw an endocrinologist, despite her having a stable and long-term prescription. As one can imagine, this threw this woman into a cycle of health roadblocks and frustration. Her new GP refused to prescribe HRT and passed the buck to an endocrinologist. In turn, the endocrinologist at her new hospital passed the buck and demanded unredacted psychiatric reports from almost a decade ago that included all kinds of deeply private and traumatic details of her history.

This is not an isolated case. It is all too common and it is not on. Barrier after barrier was put in front of this trans woman to simply continue the treatment she had been properly prescribed for the previous nine years simply because she decided to move to a new area. Doctors are judging patients when they should be caring for them. She tells me that if she does not continue her hormonal treatment, she risks a range of severe health risks ranging from osteoporosis to cardiovascular issues, depression and cognitive decline. Like many caught in the same position, she is actively considering sourcing her hormones online, with all of the risk and lack of regulation that entails. That is not something anyone can stand over but she is being driven to at least consider doing it. There can be no postcode lottery when it comes to access to healthcare, nor can it depend on the whim of any one medical professional.

As the Minister has heard from my colleagues, this one case is unfortunately broadly representative of many people's struggles to access basic decent healthcare with dignity and equality. As was said earlier, our record in this country in this area is appalling. We are well behind our European neighbours. We need to do better, as the Minister and the Minister of State, Deputy Butler, have acknowledged. This is not only a trans issue; it is a human rights issue. We either believe in equal access to appropriate healthcare for all our citizens or we do not. Rights are not to be debated. They are inherent. The Minister accepts that the situation needs to change. She has outlined the process we are in at the moment. This is welcome. We in Labour will work with her to deliver a better system of healthcare for trans people in our society, the kind of system this Republic and its citizens demand.

See this speech in context